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Good Lira. Groat Serv=ce. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2112001104-0 Pages: 1 <br />Debtor Name: ABDUL MAHMOUD <br />Filing Date and Time: 12/21/2021 10:14 AM <br />Notice of State Tax Lien <br />202110$00 <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tex <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand. These taxes are a lien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien.This lien will expire and <br />become unenforceable 10 years after the data of recording If no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />91866669 <br />Federal tO Number <br />Use Serial Number <br />12187465 <br />Lien Fled With: <br />Social Security Number <br />XXX -XX -6866 <br />Spouse's Social Secueity Ranter <br />® Register of Deeds ■ County clerk <br />Date of Lien <br />December 16, 2021 <br />Lien Type: <br />®orginai QConinuation ❑Corrected <br />County <br />HALL <br />us SS Name end Location Address <br />Taxpayer Name and Mailing Address <br />ABDUL MAHMOUD <br />114 NEEDY ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2019 <br />09/23/2020 <br />$295.00 <br />$14.75 <br />$15.32 <br />325.07 <br />Total <br />$325.07 <br />I certify that the Nebraska Department of Revenue has compiled with the laws of the State of Nebraska in determining the amount shown lobe due, <br />and that the taxpayer has faded to pay the amount due after demand. This Notice of State Tax Lien is an effective Nan and serves to continue the priority of <br />the States interest in the affected property of the taxpayer. <br />sign 6 Az4..4ta. Saute Revenue Agent 12/16/2021 (402)471-5833 <br />here r Proparer n Signature TNN Date Phone Number <br />,t%& Revenue Supervisor 12/16/2021 <br />Authorized Signature Title Date <br />4454-1974 Rev. 84016 Supersedes 4.545-1574 Bev..114013 <br />